6. Severe and complex
(morbid) obesity is a
phrase commonly used for
patients with body mass
index (BMI) ≥35 and
obesity-related disease.
BMI ≥40 by itself
7. Effects of
obesity
• Obesity and lack of
physical activity have the
second largest public
health impact after
smoking.
• Severe obesity increases
the risk of cancer, is
associated with multiple
other diseases,
• affects quality of life and
reduces life expectancy by
5–20 years.
13. Aetiology
• Obesity runs in
families and social
networks
• Very few obese
people have an
identifiable genetic,
hormonal basis such
as Prader–Willi
syndrome
26. Bariatric
surgery
Bariatric surgery is the branch of surgery involving
manipulation of the stomach and/or small bowel to aid
weight loss
Dieting, increasing energy expenditure through exercise,
and intensive lifestyle intervention, are successful for
most obese people in helping them lose 6–8% body
weight in the short term, up to 1–3 years. Reaching a
plateau and cyclical rebound weight regain
Currently there is no available pharmacotherapy that is
safe and clinically or cost-effective in the long term, and
there is none on the horizon remotely as effective as
bariatric surgery
27. Bariatric
surgery
Bariatric surgery leads to weight
loss of 25–35% of body weight
(usually at least 15 kg) after 1
year, and this is sustained at 15–
25% after 20 years
Additional benefits are that most
or all of the obesity-related
diseases improve as weight is
lost. Quality of life improves.
32. Principle
The mechanism of action of most
weight-loss procedures remains
incompletely understood.
Reduced appetite and early satiety
are common features that are
potentially explained by changes in
levels of gut hormones, such as PYY
and GLP-1, and how these interact
with the brain.
